Would you tell us a little bit about your background, qualifications and broad interest in JDM?

I am a pediatric rheumatologist and early career investigator at the University of Michigan, committed to devoting my career to answering clinically relevant questions through translational research in pediatric rheumatology. I began my research career in pediatric rheumatology by investigating novel urine biomarkers for lupus nephritis in children. Through studying pediatric lupus, I became interested in the overlap of common disease symptoms and pathways with JDM and recognized a significant gap in our knowledge of what triggers onset and chronicity of JDM. In particular, I wondered whether skin inflammation in JDM can initiate multiorgan inflammation or influence the course of the disease over time.

Tell us about your research institute, and what is it currently doing for JDM patient care and JDM research programs?

At the University of Michigan, we use a multidisciplinary approach to diagnose and treat children with JDM, with the goal of helping our patients regain their health and get back to the activities they enjoy most. We are active in recruiting patients for research studies through the Childhood Arthritis and Rheumatology Research Alliance (CARRA). We are in the early stages of developing our own prospective cohort of JDM patients. The participation of children in this registry will allow us to determine whether candidate biomarkers and pathways can predict subsequent disease course. We have a close relationship with our colleagues in adult rheumatology and plan to pursue studies to identify differences in disease pathways activated in adults vs. children. My primary research mentor in adult rheumatology, Dr. Michelle Kahlenberg, is an expert in the pathogenic mechanisms of cutaneous autoimmune disease. We also have collaborators in dermatology, computational medicine, pathology and at a Cure JM Center of Excellence in Chicago to strengthen our research moving forward.

What will this grant enable you to study in JDM?

This grant will allow us to characterize unique molecular signatures and inflammatory cell subpopulations in skin from JDM patients with varying clinical disease phenotypes.

Why is this study so important?

In JDM, we know that skin inflammation can be a presenting symptom and that persistent skin disease is predictive of disease chronicity. Improving our understanding of biological pathways initiating skin inflammation in JDM could lend insight into mechanisms of systemic disease activation and progression.

How do think this study will impact JDM scientific knowledge and JDM patient care?

This study will not only contribute to our understanding of disease pathogenesis and potentially disease activation or progression, but it will also identify candidate genes and biological pathways for biomarker development and therapeutic intervention, leading to improved, more specific, less toxic therapies for patients and ideally intervention prior to clinical onset of disease.

Can you share your vision for the potential outcomes in JDM in this area in the next five years?

I know that we will witness significant improvements in JDM care over the next five years. Given that we now have more clinical providers to optimally manage care for JDM patients, we have the ability to devote more time to much needed research in JDM. I anticipate that bioinformatic approaches to the study of JDM disease mechanisms will inform us of unique inflammatory pathways that could be targeted for treatment and also aid in molecular classification of disease severity. We will be able to predict which patients will develop particular disease complications so that we might be better able to prevent these complications. We will also know how to determine individualized therapy plans based on a patient's disease phenotype.

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